Lipoprotein(a) and cardiovascular risk in adult Mexicans.

A cross-epidemiologic study concerning cardiovascular risk factors in a random sample population of Mexico City was carried out in 1991 and 1992. Lipoprotein(a) (Lp(a)) levels in 404 men and 311 women aged 20-90 years were determined by enzyme-linked immunoassay on fasting plasma. Men and women showed similar age-adjusted Lp(a) values. For the whole population the median Lp(a) was 6.9 mg/dL and the prevalence of high Lp(a) (> 30 mg/dL) was 14%. Small positive correlations between Lp(a) and plasma cholesterol (rs = 0.16) and low density lipoprotein cholesterol (LDL-C) (rs = 0.21), and a negative one with insulin (rs = -0.13) were found. In a multiple regression analysis, insulin and LDL-C were the variables that best explained the variation of Lp(a) in our sample. Our data show that Lp(a) in our population is similar to that found in other populations. An association of Lp(a) with myocardial infarction was observed (high Lp(a) was seen in 33% of atherosclerotic individuals versus 14% in healthy subjects) but did not reach statistical significance.

[Lipoprotein(a) in heterozygote familial hypercholesterolemia]. / Lipoproteína(a) en hipercolesterolemia familiar heterocigota.

Familial hypercholesterolemia (FH) is the genetic lipid disorder with a higher risk to develop coronary heart disease (CHD). In the heterozygous patients there are, however, variability in the atherosclerosis age of onset and severity. In recent years, it has been reported elevated levels of Lp(a) in FH, and it is proposed that this lipoprotein contributes to the development of CHD in these patients. This study evaluates the relationship between Lp(a) levels and the presence of CHD in FH. We included 38 patients with heterozygous FH with or without CHD (13 and 25 respectively), and a control group. In comparison to the control group, FH patients had significant elevated levels of Lp(a) (median 8.1 vs 16 mg/dL), and a greater prevalence of hyper Lp(a) (with a cut-off level of 30 mg/dL) (11.4 vs 25.7%). FH patients with CHD had higher levels of Lp(a) than those without CHD (22.8 vs 14.4 mg/dL). A significative negative correlation between age of onset of CHD and Lp(a) levels was found in females. CHD in FH was associated with male gender, older age, higher prevalence of hypertension, higher waist/hip ratios, higher levels of triglycerides and prevalence of hypertriglyceridemia. Our findings suggest that Lp(a) may play a role as an additional risk factor to develop atherosclerosis in FH.